Eaglet Health LLC

Key facts

NPI

1407645583

Entity type

Organization (NPI type 2)

Primary specialty

Infusion Therapy Clinic/Center 261QI0500X

Legal business name

EAGLET HEALTH LLC

Practice address

4401 W Memorial Rd Ste 135
Oklahoma City, OK 73134-1787

Phone

(405) 442-7577

Fax

(405) 442-7223

NPI assigned

May 5, 2025

Organization subpart

No

Authorized official

Name

Linda Nola, RN

Title

Administrator/ Manager

Phone

(405) 604-7498

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lacey Gann, APRN-CNP Family Nurse Practitioner · Yukon, OK · NPI 1366200792
  Medicare reassignment Care Compare group NPD OK
• David A Long II, M.D. Emergency Medical Services (Emergency Medicine) Physician · Moore, OK · NPI 1922065069
  Medicare reassignment Care Compare group NPD OK
• Sarah Elizabeth Busacco, APRN-CNP General Practice Physician · Chickasha, OK · NPI 1235955055
  Medicare reassignment Care Compare group OK

Medicare participation

Medicare fee-for-service enrollment

Enrolled in OK

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

Other names

• Premier Infusion Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 2, 2025.

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1407645583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 W MEMORIAL RD STE 135",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341787",
            "telephone_number": "405-604-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 W MEMORIAL RD STE 135",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341787",
            "telephone_number": "405-442-7577",
            "fax_number": "405-442-7223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLET HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A",
        "authorized_official_last_name": "NOLA",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "ADMINISTRATOR/ MANAGER",
        "authorized_official_telephone_number": "405-604-7498",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Infusion Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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All providers in Oklahoma City, OK · Infusion Therapy Clinic/Center in Oklahoma